2,666 research outputs found
A novel multivariate STeady-state index during general ANesthesia (STAN)
The assessment of the adequacy of general anesthesia for surgery, namely the nociception/anti-nociception balance, has received wide attention from the scientific community. Monitoring systems based on the frontal EEG/EMG, or autonomic state reactions (e.g. heart rate and blood pressure) have been developed aiming to objectively assess this balance. In this study a new multivariate indicator of patients' steady-state during anesthesia (STAN) is proposed, based on wavelet analysis of signals linked to noxious activation. A clinical protocol was designed to analyze precise noxious stimuli (laryngoscopy/intubation, tetanic, and incision), under three different analgesic doses; patients were randomized to receive either remifentanil 2.0, 3.0 or 4.0Â ng/ml. ECG, PPG, BP, BIS, EMG and [Formula: see text] were continuously recorded. ECG, PPG and BP were processed to extract beat-to-beat information, and [Formula: see text] curve used to estimate the respiration rate. A combined steady-state index based on wavelet analysis of these variables, was applied and compared between the three study groups and stimuli (Wilcoxon signed ranks, Kruskal-Wallis and Mann-Whitney tests). Following institutional approval and signing the informed consent thirty four patients were enrolled in this study (3 excluded due to signal loss during data collection). The BIS index of the EEG, frontal EMG, heart rate, BP, and PPG wave amplitude changed in response to different noxious stimuli. Laryngoscopy/intubation was the stimulus with the more pronounced response [Formula: see text]. These variables were used in the construction of the combined index STAN; STAN responded adequately to noxious stimuli, with a more pronounced response to laryngoscopy/intubation (18.5-43.1Â %, [Formula: see text]), and the attenuation provided by the analgesic, detecting steady-state periods in the different physiological signals analyzed (approximately 50Â % of the total study time). A new multivariate approach for the assessment of the patient steady-state during general anesthesia was developed. The proposed wavelet based multivariate index responds adequately to different noxious stimuli, and attenuation provided by the analgesic in a dose-dependent manner for each stimulus analyzed in this study.The first author was supported by a scholarship from the Portuguese Foundation for Science and Technology (FCT SFRH/BD/35879/2007). The authors would also like to acknowledge the support of UISPAâSystem Integration and Process Automation UnitâPart of the LAETA (Associated Laboratory of Energy,
Transports and Aeronautics) a I&D Unit of the Foundation for Science and Technology (FCT), Portugal. FCT support under project PEst-OE/EME/LA0022/2013.info:eu-repo/semantics/publishedVersio
Oral tolerance to cancer can be abrogated by T regulatory cell inhibition
Oral administration of tumour cells induces an immune hypo-responsiveness known as oral tolerance. We have previously shown that oral tolerance to a cancer is tumour antigen specific, non-cross-reactive and confers a tumour growth advantage. We investigated the utilisation of regulatory T cell (Treg) depletion on oral tolerance to a cancer and its ability to control tumour growth. Balb/C mice were gavage fed homogenised tumour tissue â JBS fibrosarcoma (to induce oral tolerance to a cancer), or PBS as control. Growth of subcutaneous JBS tumours were measured; splenic tissue excised and flow cytometry used to quantify and compare systemic Tregs and T effector (Teff) cell populations. Prior to and/or following tumour feeding, mice were intraperitoneally administered anti-CD25, to inactivate systemic Tregs, or given isotype antibody as a control. Mice which were orally tolerised prior to subcutaneous tumour induction, displayed significantly higher systemic Treg levels (14% vs 6%) and faster tumour growth rates than controls (p<0.05). Complete regression of tumours were only seen after Treg inactivation and occurred in all groups - this was not inhibited by tumour feeding. The cure rates for Treg inactivation were 60% during tolerisation, 75% during tumour growth and 100% during inactivation for both tolerisation and tumour growth. Depletion of Tregs gave rise to an increased number of Teff cells. Treg depletion post-tolerisation and post-tumour induction led to the complete regression of all tumours on tumour bearing mice. Oral administration of tumour tissue, confers a tumour growth advantage and is accompanied by an increase in systemic Treg levels. The administration of anti-CD25 Ab decreased Treg numbers and caused an increase in Teffs. Most notably Treg cell inhibition overcame established oral tolerance with consequent tumor regression, especially relevant to foregut cancers where oral tolerance is likely to be induced by the shedding of tumour tissue into the gut
Quality Control of Motor Unit Number Index (MUNIX) Measurements in 6 Muscles in a Single-Subject âRound-Robinâ Setup
Background
Motor Unit Number Index (MUNIX) is a neurophysiological measure that provides an index
of the number of lower motor neurons in a muscle. Its performance across centres in healthy
subjects and patients with Amyotrophic Lateral Sclerosis (ALS) has been established, but
inter-rater variability between multiple raters in one single subject has not been
investigated.
Objective
To assess reliability in a set of 6 muscles in a single subject among 12 examiners (6 experienced
with MUNIX, 6 less experienced) and to determine variables associated with variability
of measurements.
Methods
Twelve raters applied MUNIX in six different muscles (abductor pollicis brevis (APB),
abductor digiti minimi (ADM), biceps brachii (BB), tibialis anterior (TA), extensor dig. brevis
(EDB), abductor hallucis (AH)) twice in one single volunteer on consecutive days. All raters
visited at least one training course prior to measurements. Intra- and inter-rater variability as
determined by the coefficient of variation (COV) between different raters and their levels of
experience with MUNIX were compared.
Results
Mean intra-rater COV of MUNIX was 14.0% (±6.4) ranging from 5.8 (APB) to 30.3% (EDB).
Mean inter-rater COV was 18.1 (±5.4) ranging from 8.0 (BB) to 31.7 (AH). No significant differences
of variability between experienced and less experienced raters were detected.
Conclusion
We provide evidence that quality control for neurophysiological methods can be performed
with similar standards as in laboratory medicine. Intra- and inter-rater variability of MUNIX is
muscle-dependent and mainly below 20%. Experienced neurophysiologists can easily
adopt MUNIX and adequate teaching ensures reliable utilization of this method
Cardy and Kerr
The Kerr/CFT correspondence employs the Cardy formula to compute the entropy
of the left moving CFT states. This computation, which correctly reproduces the
Bekenstein--Hawking entropy of the four-dimensional extremal Kerr black hole,
is performed in a regime where the temperature is of order unity rather than in
a high-temperature regime. We show that the comparison of the entropy of the
extreme Kerr black hole and the entropy in the CFT can be understood within the
Cardy regime by considering a D0-D6 system with the same entropic properties.Comment: 20 pages; LaTeX; JHEP format; v.2 references added, v.3 Section 4
adde
Challenges for Routine Health System Data Management in a Large Public Programme to Prevent Mother-to-Child HIV Transmission in South Africa
Background: Recent changes to South Africa's prevention of mother-to-child transmission of HIV (PMTCT) guidelines have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. While programmatic efforts to reach this target are underway, obtaining complete and accurate data from clinical sites to track progress presents a major challenge. We assessed the completeness and accuracy of routine PMTCT data submitted to the district health information system (DHIS) in three districts of Kwazulu-Natal province, South Africa. Methodology/Principal Findings: We surveyed the completeness and accuracy of data reported for six key PMTCT data elements between January and December 2007 from all 316 clinics and hospitals in three districts. Through visits to randomly selected sites, we reconstructed reports for the same six PMTCT data elements from clinic registers and assessed accuracy of the monthly reports previously submitted to the DHIS. Data elements were reported only 50.3% of the time and were âaccurateâ (i.e. within 10% of reconstructed values) 12.8% of the time. The data element âAntenatal Clients Tested for HIVâ was the most accurate data element (i.e. consistent with the reconstructed value) 19.8% of the time, while âHIV PCR testing of baby born to HIV positive motherâ was the least accurate with only 5.3% of clinics meeting the definition of accuracy. Conclusions/Significance: Data collected and reported in the public health system across three large, high HIV-prevalence Districts was neither complete nor accurate enough to track process performance or outcomes for PMTCT care. Systematic data evaluation can determine the magnitude of the data reporting failure and guide site-specific improvements in data management. Solutions are currently being developed and tested to improve data quality
Multiscale photosynthetic exciton transfer
Photosynthetic light harvesting provides a natural blueprint for
bioengineered and biomimetic solar energy and light detection technologies.
Recent evidence suggests some individual light harvesting protein complexes
(LHCs) and LHC subunits efficiently transfer excitons towards chemical reaction
centers (RCs) via an interplay between excitonic quantum coherence, resonant
protein vibrations, and thermal decoherence. The role of coherence in vivo is
unclear however, where excitons are transferred through multi-LHC/RC aggregates
over distances typically large compared with intra-LHC scales. Here we assess
the possibility of long-range coherent transfer in a simple chromophore network
with disordered site and transfer coupling energies. Through renormalization we
find that, surprisingly, decoherence is diminished at larger scales, and
long-range coherence is facilitated by chromophoric clustering. Conversely,
static disorder in the site energies grows with length scale, forcing
localization. Our results suggest sustained coherent exciton transfer may be
possible over distances large compared with nearest-neighbour (n-n) chromophore
separations, at physiological temperatures, in a clustered network with small
static disorder. This may support findings suggesting long-range coherence in
algal chloroplasts, and provides a framework for engineering large chromophore
or quantum dot high-temperature exciton transfer networks.Comment: 9 pages, 6 figures. A significantly updated version is now published
online by Nature Physics (2012
Revisiting Scalar and Pseudoscalar Couplings with Nucleons
Certain dark matter interactions with nuclei are mediated possibly by a
scalar or pseudoscalar Higgs boson. The estimation of the corresponding cross
sections requires a correct evaluation of the couplings between the scalar or
pseudoscalar Higgs boson and the nucleons. Progress has been made in two
aspects relevant to this study in the past few years. First, recent lattice
calculations show that the strange-quark sigma term and the
strange-quark content in the nucleon are much smaller than what are expected
previously. Second, lattice and model analyses imply sizable SU(3) breaking
effects in the determination on the axial-vector coupling constant that
in turn affect the extraction of the isosinglet coupling and the
strange quark spin component from polarized deep inelastic
scattering experiments. Based on these new developments, we re-evaluate the
relevant nucleon matrix elements and compute the scalar and pseudoscalar
couplings of the proton and neutron. We also find that the strange quark
contribution in both types of couplings is smaller than previously thought.Comment: 17 pages, Sec. II is revised and the pion-nucleon sigma term
extracted from the scattering data is discussed. Version to appear in JHE
Long gamma-ray bursts and core-collapse supernovae have different environments
When massive stars exhaust their fuel they collapse and often produce the
extraordinarily bright explosions known as core-collapse supernovae. On
occasion, this stellar collapse also powers an even more brilliant relativistic
explosion known as a long-duration gamma-ray burst. One would then expect that
long gamma-ray bursts and core-collapse supernovae should be found in similar
galactic environments. Here we show that this expectation is wrong. We find
that the long gamma-ray bursts are far more concentrated on the very brightest
regions of their host galaxies than are the core-collapse supernovae.
Furthermore, the host galaxies of the long gamma-ray bursts are significantly
fainter and more irregular than the hosts of the core-collapse supernovae.
Together these results suggest that long-duration gamma-ray bursts are
associated with the most massive stars and may be restricted to galaxies of
limited chemical evolution. Our results directly imply that long gamma-ray
bursts are relatively rare in galaxies such as our own Milky Way.Comment: 27 pages, 4 figures, submitted to Nature on 22 August 2005, revised 9
February 2006, online publication 10 May 2006. Supplementary material
referred to in the text can be found at
http://www.stsci.edu/~fruchter/GRB/locations/supplement.pdf . This new
version contains minor changes to match the final published versio
Association analyses of the MAS-QTL data set using grammar, principal components and Bayesian network methodologies
<p>Abstract</p> <p>Background</p> <p>It has been shown that if genetic relationships among individuals are not taken into account for genome wide association studies, this may lead to false positives. To address this problem, we used Genome-wide Rapid Association using Mixed Model and Regression and principal component stratification analyses. To account for linkage disequilibrium among the significant markers, principal components loadings obtained from top markers can be included as covariates. Estimation of Bayesian networks may also be useful to investigate linkage disequilibrium among SNPs and their relation with environmental variables.</p> <p>For the quantitative trait we first estimated residuals while taking polygenic effects into account. We then used a single SNP approach to detect the most significant SNPs based on the residuals and applied principal component regression to take linkage disequilibrium among these SNPs into account. For the categorical trait we used principal component stratification methodology to account for background effects. For correction of linkage disequilibrium we used principal component logit regression. Bayesian networks were estimated to investigate relationship among SNPs.</p> <p>Results</p> <p>Using the Genome-wide Rapid Association using Mixed Model and Regression and principal component stratification approach we detected around 100 significant SNPs for the quantitative trait (p<0.05 with 1000 permutations) and 109 significant (p<0.0006 with local FDR correction) SNPs for the categorical trait. With additional principal component regression we reduced the list to 16 and 50 SNPs for the quantitative and categorical trait, respectively.</p> <p>Conclusions</p> <p>GRAMMAR could efficiently incorporate the information regarding random genetic effects. Principal component stratification should be cautiously used with stringent multiple hypothesis testing correction to correct for ancestral stratification and association analyses for binary traits when there are systematic genetic effects such as half sib family structures. Bayesian networks are useful to investigate relationships among SNPs and environmental variables.</p
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